In a move that reflects a growing trend in the U.S. pharmaceutical market, UnitedHealth Group Inc. (UNH) announced on Tuesday it will remove AbbVie Inc.’s (ABBV) blockbuster drug Humira from some of its preferred reimbursement lists starting January 1, 2025. The company will instead recommend lower-cost biosimilar versions, highlighting a focus on cost-cutting measures.
This decision makes UnitedHealth the last of the three largest U.S. pharmacy benefit managers (PBMs) to exclude Humira. Cigna Corporation (CI) announced a similar plan last month, following a similar move by CVS Health Inc.’s (CVS) Caremark unit in April. The shift towards biosimilars has been evident, particularly after CVS’s action, which led to a significant increase in patients transitioning to Sandoz Group AG’s (SDZNY, SDZXF) biosimilar version of Humira within just three weeks.
UnitedHealth’s preferred biosimilar list includes Amgen Inc’s (AMGN) Amjevita, managed by its pharmacy benefits unit, Optum Rx. Cigna also plans to cover biosimilars like Boehringer Ingelheim’s Cyltezo, Simlandi from Teva Pharmaceutical Industries Ltd (TEVA), and Alvotech’s (ALVO) products, including an unbranded version of Sandoz’s Hyrimoz, as replacements for Humira.
However, patients will still have access to Humira until the Food and Drug Administration (FDA) designates the preferred biosimilars as interchangeable with the original drug. This designation is expected in 2025. Despite the growing competition, AbbVie has maintained a dominant share of the U.S. Humira market throughout 2023, achieving this through favorable negotiations with PBMs even as biosimilar alternatives entered the market.
According to a Reuters report, Humira has retained over 80% of its patients despite the lower-priced rivals entering the market over the past year. The report attributes this to pharmacy benefit managers’ influence on patient access, with minimal incentive for doctors to switch to biosimilars.
In May, Cantor Fitzgerald noted that AbbVie had positioned itself to absorb the erosion caused by Humira biosimilars and achieve modest operational revenue growth.
Following the announcement, UNH stock declined by 2% to $587.07 at the close of trading on Wednesday.
This move by UnitedHealth underscores a growing trend in the healthcare industry to reduce costs by promoting lower-cost alternatives to expensive medications. As biosimilar options become increasingly available, it remains to be seen how this will impact the market share of original brand-name drugs.
